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Paediatric Imaging

Hepatosplenomegaly

enlargement of the liver and spleen to a degree that they are clinically palpable. There are a large number of causes in childhood, many of which overlap the causes of isolated hepatomegaly and splenomegaly. A list of conditions is given in Table 1. Any cause of chronic liver disease may cause portal hypertension and so is a possible cause of hepatosplenomegaly. Splenic enlargement displaces the stomach medially and the splenic flexure downward, liver enlargement is not reliably assessed on radiographs. Spleen size as measured on ultrasound can be compared with normograms. Hepatic size is not reliably assessed on radiographs.

Hepatosplenomegaly, Table 1. Causes of hepatosplenomegaly.

Metabolic
Haematologic
myeloproliferative disorders
myelofibrosis
Oncologic
leukaemia
lymphoma
Infective
viral
hepatitis
rubella
cytomegalovirus disease
infectious mononucleosis
parasitic
malaria
leischmaniasis

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